Complicated urinary-tract infections
▶BY MOUTH
▶Neonate: 10 mg/kg twice daily.▶Child: 10 mg/kg twice daily, dose to be doubled in
severe infection (max. 750 mg twice daily)
▶BY INTRAVENOUS INFUSION
▶Neonate: 6 mg/kg every 12 hours, to be given over
60 minutes.▶Child: 6 mg/kg every 8 hours; increased to 10 mg/kg
every 8 hours (max. per dose 400 mg), in severe
infection
Gonorrhoea
▶BY MOUTH
▶Child 12–17 years: 500 mg for 1 dose
Anthrax (treatment and post-exposure prophylaxis)
▶BY MOUTH
▶Child: 15 mg/kg twice daily (max. per dose 500 mg)
▶BY INTRAVENOUS INFUSION
▶Child: 10 mg/kg every 12 hours (max. per dose 400 mg)
Prevention of secondary case of meningococcal meningitis
▶BY MOUTH
▶Neonate: 30 mg/kg (max. per dose 125 mg) for 1 dose.▶Child 1 month–4 years: 30 mg/kg (max. per dose 125 mg)
for 1 dose
▶Child 5–11 years: 250 mg for 1 dose
▶Child 12–17 years: 500 mg for 1 doselUNLICENSED USENot licensed for use in children under
1 year of age. Licensed for use in children over 1 year for
complicated urinary-tract infections, for pseudomonal
lower respiratory-tract infections in cysticfibrosis, for
prophylaxis and treatment of inhalational anthrax.
Licensed for use in children over 1 year for other infections
where the benefit is considered to outweigh the potential
risks. Not licensed for use in children for gastro-intestinal
anthrax. Not licensed for use in children for prophylaxis of
meningococcal meningitis.
lCAUTIONSAcute myocardial infarction (risk factor for QT
interval prolongation).avoid excessive alkalinity of urine
(risk of crystalluria).bradycardia (risk factor for QT
interval prolongation).congenital long QT syndrome (risk
factor for QT interval prolongation).electrolyte
disturbances (risk factor for QT interval prolongation).
ensure adequatefluid intake (risk of crystalluria).heart
failure with reduced left ventricular ejection fraction (risk
factor for QT interval prolongation).history of
symptomatic arrhythmias (risk factor for QT interval
prolongation)
lINTERACTIONS→Appendix 1 : quinolones
lSIDE-EFFECTS
▶Common or very commonArthropathy
▶UncommonAkathisia.fungal superinfection.
musculoskeletal pain.oedema.renal impairment.
sensation abnormal.thrombocytosis.vasodilation
▶Rare or very rareAntibiotic associated colitis.asthma.
bone marrow disorders.crystalluria.erythema nodosum.
gait abnormal.haematuria.intracranial pressure
increased.leucocytosis.migraine.muscle cramps.muscle
tone increased.olfactory nerve disorder.petechiae.status
epilepticus
▶Frequency not knownMood altered.severe cutaneous
adverse reactions (SCARs)
lPREGNANCYA single dose of ciprofloxacin may be used for
the prevention of a secondary case of meningococcal
meningitis.
lBREAST FEEDINGAmount too small to be harmful but
manufacturer advises avoid.
lRENAL IMPAIRMENT
Dose adjustmentsReduce dose if estimated glomerular
filtration rate less than 30 mL/minute/ 1. 73 m^2 —consult
product literature.
lPRESCRIBING AND DISPENSING INFORMATION
▶With oral useFlavours of oral liquid formulations may
include strawberry.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Ciprofloxacin for bacterial
infectionswww.medicinesforchildren.org.uk/ciprofloxacin-
bacterial-infections- 0
Driving and skilled tasksMay impair performance of skilled
tasks (e.g. driving); effects enhanced by alcohol.lMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: oral suspension
Tablet
CAUTIONARY AND ADVISORY LABELS7, 9, 25
▶Ciprofloxacin (Non-proprietary)
Ciprofloxacin (as Ciprofloxacin hydrochloride)
100 mgCiprofloxacin 100 mg tablets| 6 tabletP£ 4. 50 DT =
£ 1. 97
Ciprofloxacin (as Ciprofloxacin hydrochloride)
250 mgCiprofloxacin 250 mg tablets| 10 tabletP£ 7. 25 DT =
£ 0. 39 | 20 tabletP£ 0. 78 – £ 11. 20 | 100 tabletP£ 5. 90
Ciprofloxacin (as Ciprofloxacin hydrochloride)
500 mgCiprofloxacin 500 mg tablets| 10 tabletP£ 14. 00 DT =
£ 0. 71 | 20 tabletP£ 1. 42 – £ 21. 23 | 100 tabletP£ 8. 20
Ciprofloxacin (as Ciprofloxacin hydrochloride)
750 mgCiprofloxacin 750 mg tablets| 10 tabletP£ 20. 00 DT =
£ 8. 00
▶Ciproxin(Bayer Plc)
Ciprofloxacin (as Ciprofloxacin hydrochloride) 500 mgCiproxin
500 mg tablets| 10 tabletP£ 12. 49 DT = £ 0. 71
Ciprofloxacin (as Ciprofloxacin hydrochloride) 750 mgCiproxin
750 mg tablets| 10 tabletP£ 17. 78 DT = £ 8. 00
Oral suspension
CAUTIONARY AND ADVISORY LABELS7, 9, 25
▶Ciproxin(Bayer Plc)
Ciprofloxacin 50 mg per 1 mlCiproxin 250 mg/ 5 ml oral suspension
| 100 mlP£ 21. 29 DT = £ 21. 29
Solution for infusion
ELECTROLYTES:May contain Sodium
▶Ciprofloxacin (Non-proprietary)
Ciprofloxacin (as Ciprofloxacin lactate) 2 mg per
1mlCiprofloxacin 200 mg/ 100 ml solution for infusion vials|
1 vialP£ 2. 00 – £ 5. 00
Ciprofloxacin 200 mg/ 100 ml solution for infusion bottles|
10 bottleP£ 14. 45
Ciprofloxacin 100 mg/ 50 ml solution for infusion vials| 1 vialP
£ 2. 25 – £ 7. 20
Ciprofloxacin 400 mg/ 200 ml solution for infusion bottles|
1 bottleP£ 6. 00 | 10 bottleP£ 195. 90
Ciprofloxacin 400 mg/ 200 ml solution for infusion vials| 1 vialP
£ 2. 50
▶Ciproxin(Bayer Plc)
Ciprofloxacin (as Ciprofloxacin lactate) 2 mg per 1 mlCiproxin
Infusion 100 mg/ 50 ml solution for infusion bottles| 1 bottleP
£ 7. 61 (Hospital only)
Ciproxin Infusion 400 mg/ 200 ml solution for infusion bottles|
5 bottleP£ 114. 23 (Hospital only)
Ciproxin Infusion 200 mg/ 100 ml solution for infusion bottles|
5 bottleP£ 75. 06 (Hospital only)
Infusion
▶Ciprofloxacin (Non-proprietary)
Ciprofloxacin (as Ciprofloxacin lactate) 2 mg per
1mlCiprofloxacin 200 mg/ 100 ml infusion bags| 5 bagP£ 60. 00
(Hospital only)
Ciprofloxacin 400 mg/ 200 ml infusion bags| 5 bagP£ 85. 00 |
10 bagP£ 200. 00 (Hospital only)BNFC 2018 – 2019 Bacterial infection 349
Infection5